An item employed in many oral surgery and orthodontic procedures is a dental dam. The rubber dental dam is known in the art and has been utilized in dentistry since 1864. It comprises a thin flexible piece of rubber employed to isolate one or more teeth during various dental procedures. The purpose for using the rubber dental dam is to provide an optimum working environment for the dentist while protecting the patient during operative procedures.
The dam not only eliminates saliva from the field of operation, but also mildly retracts the soft tissue around the tooth, particularly when the operative procedure is a class V type operation. Most procedures in operative dentistry are performed more efficiently by employing a dental dam as it assures a dry working area during all steps of the procedure. This is particularly true when an operation is on a carious lesion where the pulp may be exposed; the dental dam then minimizes pulpal contamination. Another advantage to operating in a dry field is that dental restorative materials do not develop their full properties in a wet operating environment. The rubber dam then permits a dentist to obtain the expected physical properties of materials because of the dry field.
The dental dam also protects the patient and the practitioner. The rubber dental dam protects the patient from the possibility of aspirating or swallowing debris. Also, the dam will permit prompt recovery of small instruments such as thin files dropped during the operative procedure. The dental dam also affords the practitioner protection from any infectious disease that may be present in the patient's mouth.
To employ a dental dam, the dam can first be placed around and attached to, a Young holder; which is a frame for the dental dam. Holes are subsequently punched in the dam such that each hole corresponds to a tooth that will be placed therethrough. The dental dam is then lubricated to facilitate the passing of the dam through the tooth crown contact points. Alternatively, the holes are punched first, the dam is installed over the teeth and is then stretched over the frame. In either order, the dental dam then must be stabilized by a retainer means.
The retainer clamp is the most common prior art form of stabilizing a dental dam and consists of four prongs and two jaws connected by a bow. The problem with utilizing a retainer clamp is that the clamp is not ideally configured for a specific tooth. Due to the variation in teeth across a single mouth, from sharp thin incisors to broad wide molars, many type of teeth are encountered. Further, every mouth has different sizes and shapes of teeth. As a result, with specific clamps designed for specific teeth, many types of retainer clamps need to be stocked by the practitioner.
Another disadvantage in employing the dental dam retainer clamp is that the four prongs must contact the tooth, if they do not, the clamp may need to be ground, a process requiring still more time. Furthermore, even with four point contact, the retainer can injure the gingiva, as well as the tooth, resulting in post-operative soreness. Accurate placement of the clamps is difficult to achieve and as a result, the patient may need to be anesthetized allowing for more comfortable retainer placement on the anchor tooth. The clamp may also create sealing problems on the anchor tooth which then creates leakage problems of wetness into the work area.
To correct this and the problems discussed above, some dentists place dental tape or floss around the tooth gingival and tie a surgeon's knot, as is well known in the art. While this method is effective, it is time consuming and requires a skilled dentist to employ. However, often a dental assistant installs the dental dam, thereby making this method ineffective.
To cure this problem, a simpler method has been employed. That method is to cut away a corner of the dental dam, roll it, and place the rolled portion into a diastema to serve as an anterior anchor. However, one will note that this method not only requires cutting the dam, but also would not be feasible in a narrow space. A diastema is a necessity as the unit employed as the anchor is very wide. A further problem with this method is that the retainer is obtrusive in an obviously small work area.